1,720,979 research outputs found
Nursing model to deliver respiratory research
No full textLindsay Welch and colleagues describe how a system that involves rotating nurses between a respiratory centre and a research unit has delivered research data while improving the care of patients with chronic obstructive pulmonary diseas
How do illness identity, patient workload and agentic capacity interact to shape patient and caregiver experience? Comparative analysis of lung cancer and chronic obstructive pulmonary disease.
Full text linkSome patients have to work hard to manage their illness. When this work outweighs capacity (the resources available to patients to undertake the illness workload and other workloads such as that of daily life), this may result in treatment burden, associated with poor health outcomes for patients. This cross-sectional, comparative qualitative analysis uses an abductive approach to identify, characterise and explain treatment burden in chronic obstructive pulmonary disease (COPD) and lung cancer. It uses complementary qualitative methods (semi-structured interviews with patients receiving specialist care n = 19, specialist clinicians n = 5; non-participant observation of specialist outpatient consultations in two English hospitals [11 h, 52 min] n = 41). The findings underline the importance of the diagnostic process in relation to treatment burden; whether diagnosis is experienced as a biographically disruptive shock (as with lung cancer) or is insidiously biographically erosive (as with COPD)
Informing future nursing: An exploration of respiratory teaching in the pre-registration nurse curriculum
No full textAim/objective: The aim is to examine and map the respiratory skills taught in the pre-registration nursing curriculum (2010). Background: Respiratory assessment and care are fundamental clinical skills enabling nurses to treat and care for people with acute and chronic respiratory diseases. The incidence of respiratory disease is rising, globally and most nurses will care for respiratory patients during their career. The extent of pre-registration respiratory specific education delivered in UK NMC (Nursing and Midwifery Council) approved education institutions (AEIs) is currently unknown. The move to the 2018 revised NMC standards for pre-registration nursing offers AEIs the opportunity to review provision of respiratory education. This study describes respiratory education delivered to pre-registration nurses in UK AEIs prior to implementation of the new NMC standards. Curriculum re-design can be adapted for the global nursing community. Design: This is a freedom of information survey; to gather, examine and map curriculum content.Methods: A survey of UK AEIs was conducted to initially scope provision of respiratory education for pre-registration nursing programmes. AEIs were emailed a freedom of information (FOI) request and provided information about the curriculum between April-June 2019. Results: Seventy-five UK AEIs providing pre-registration nursing programmes responded. Over half of AEIs dedicated over 4 h of teaching respiratory anatomy and physiology (60.8%), respiratory pathophysiology (75.3%) and long- term respiratory conditions (60.3%). Less than half (44.4%) spent over 4 h teaching respiratory health and prevention of respiratory disease. Just over a third spent over 4 h on respiratory pharmacology (33.8%), local and national respiratory guidelines (33.3%) and information on pulmonary rehabilitation and other interventions for the management of respiratory conditions (35.2%). In most AEIs, skills laboratories were used to teach respiratory skills. Student competence was not always assessed. Respiratory learning was reported to take place during practice placements, but this was variable. Conclusions: Variation exists in provision of respiratory education in pre-registration nursing programmes across the UK. Whilst some respiratory topics appear to be covered adequately, others have limited time on knowledge and skills teaching. New standards and curricula offer AEIs the opportunity to enhance this provision. Adaptations can be made and the curriculum transferred to the global nursing workforce. Tweetable abstract: Gaps have been identified in respiratory teaching pre-registration nurse education. Curriculum redesign to focus on respiratory care
Mental health of respiratory nurses working during the Covid-19 crisis
Full text linkThe Covid-19 pandemic has had a significant impact on all healthcare staff, particularly nurses who have been working on the front line. This article discusses the published findings of an online survey of 255 respiratory nurses that examined levels of resilience, anxiety and depression, and the experiences of these nurses during the first wave of the pandemic. The analysis showed that younger nurses who had less experience had higher levels of anxiety and depression, and lower levels of resilience. Participants highlighted concerns about the working environment, personal protective equipment, the quality of care they were able to deliver and the impact on mental health. Support for staff is essential, both throughout and after the pandemic, and must be tailored for individuals; it should also be targeted at those at higher risk of mental ill health.<br/
A negotiation of respiratory risk in the first phase of the Covid-19 pandemic
Full text linkDuring the initial phase of the Covid-19 pandemic, rapid clinical adaptations were required. Policy and guidance on pandemic infection control were scarce and evidence was developing. Countries published differing guidance on infection control and use of Personal Protective Equipment (PPE) (Birgand et al., 2020). This shifting guidance led to clinical uncertainty, particularly in respiratory nursing where aerosol-generating procedures (AGP) are commonplace. Local and personal adaptions evolved to minimise infection risk to staff, the public, and patients in clinical areas (Gov.UK, 2020).We distributed an e-survey to UK respiratory nurses via professional respiratory societies. Demographic data was collected alongside clinical role, use of PPE, and work/life balance.Just under half of the respondents (48.6%,124/255) reported undertaking AGPs; of these most wore eye protection (96.8%, 120/124), face masks (99.2%, 123/124), and gloves (99.2%, 123/124). Only 70% (87/124) wore surgical gowns. Participants were asked about their concerns about their working environment. Over a quarter focused on PPE (72/255, 28.2%) and unsafe working practices (56/255, 22.0%). Free text comments from participants reported concerns about inadequate/poor quality PPE; inconsistent advice and physical toll of the working environment in full PPE.Those working in AGP areas were significantly more worried about a lack of PPE (49/124), 39.5% versus 22/96 (22.9%) compared to non-AGP areas (P = 0.001).To ensure clinical confidence and safety health systems need to adopt evidenced international policy on PPE. Providing need clear and consistent guidance on PPE to all healthcare workers in respiratory areas in future pandemics.<br/
Barriers and facilitators to integrated cancer care between primary and secondary care: a scoping review
No full textPurpose: this scoping review identifies and characterises reported barriers and facilitators to providing integrated cancer care reported in the international literature, and develops recommendations for clinical practice.Methods: this scoping review included literature published between 2009 and 2022 and describes the delivery of integrated cancer care between primary and secondary care sectors. Searches were conducted of an online database Ovid Medline and grey literature.Results: the review included thirty-two papers. Barriers and facilitators to integrated cancer care were identified in three core areas: (1) at an individual user level around patient-healthcare professional interactions, (2) at an organisational level, and (3) at a healthcare system level. The review findings identified a need for further training for primary care professionals on cancer care, clarity in the delineation of primary care and oncologist roles (i.e. who does what), effective communication and engagement between primary and secondary care, and the provision of protocols and guidelines for follow-up care in cancer.Conclusions: information sharing and communication between primary and secondary care must improve to meet the increasing demand for support for people living with and beyond cancer. Delivering integrated pathways between primary and secondary care will yield improvements in patient outcomes and health economic costs
Impact of a comprehensive review template on personalised care in general practice for patients with multiple long-term conditions: a mixed-methods evaluation
No full textBackground: primary care is in urgent need of more effective and efficient ways of managing the care of people living with multiple long-term conditions (multimorbidity). Personalised care organised around an individual’s needs and conditions, taking account of individual context and priorities and supporting self-management, may offer an improved approach.Aim: explore the impact of a computerised template to support personalised care for patients with multiple long-term conditions within the context of routinely applied general practice.Design and setting: a convergent mixed-methods evaluation design. General practices were recruited from three areas of England: Bristol, Southampton and Staffordshire.Method: a computerised template for the review of multiple long-term conditions was made available to all general practices subscribing to a commercial template supplier. Implementation practices were supported to conduct personalised multimorbidity reviews. We used routine clinical data from implementation and control practices, a before-and-after patient questionnaire and qualitative interviews with general practice staff and patients to evaluate the impact of the intervention.Results: thirty-two general practices were recruited of which half were implementation practices. Using the multimorbidity template has potential to improve quality of care and patient benefit with no increase in consultation numbers. Patients received a more complete assessment of their needs with a clearer focus on the problems that matter most to them. Conducting multimorbidity reviews can increase burden on nursing staff and consideration is required to the organisation of reviews and appropriate training for nursing staff.Conclusion: use of the multimorbidity template needs to be supported by staff training, adequate practice capacity, support for system reorganisation, and attention to incentives to facilitate its benefits.<br/
Minimally disruptive medicine – progress 10 years later
Full text linkOne of the greatest health care challenges of the 21st Century is the rising prevalence of chronic illness and of multimorbidity, the presence of two or more chronic health conditions. Health care has responded with a rapid expansion of lifestyle and pharmacological recommendations, often formulated within single-disease guidelines and implemented across single-disease services. Patients and families are expected to navigate vast and complex care systems while integrating and enacting self-management regimens in daily life that health care delegates to them in part to accommodate the growing demands on resources posed by this tsunami of chronic illness. Furthermore, patients are expected to be active and effective participants in health care to achieve outcomes that others have valued as important, regardless of their value to the patient
Going Beyond Counting First Authors in Author Co-citation Analysis
Full text linkThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
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